News | Published October 18, 2012

Ask the pediatrician: Treating a fever, silent toddler

Dr. Collison,

What should I do if my child has a fever?

No one likes to see their little ones down with a fever. Still, there's some debate about whether to treat a fever or not.

The American Academy of Pediatrics reports that even high temperatures are not necessarily dangerous or significant, unless the child has a history of seizures, chronic disease, or is under two months of age.

We know that a fever is a good sign that a person's immune system is kicking in to fight off an infection. My own philosophy is that a child should be as comfortable as possible until the fever passes.

Two standard treatments for fevers include the use of either acetaminophen or ibuprofen. Each over-the-counter treatment has its positives and negatives, so let's take a look at which might be appropriate:

Acetaminophen is appropriate for children as young as two months old, and can be administered every four hours. It is usually easier to stomach than ibuprofen but also poses potential risks, particularly with very young children, long-term use, or overdosage. If a child's illness includes some queasiness or vomiting, acetaminophen is probably a better choice.

Ibuprofen, which lasts for six hours, typically does a better job of bringing down a fever. It is also an anti-inflammatory, better at alleviating the aches and pains that often accompany illness. It is, however, harder on the stomach so it wouldn't be my first choice if a child were vomiting.

Other Dos and Don'ts for treating a fever:

DO give the child a lukewarm bath. However, avoid rapid temperature changes.
DO give clear liquids frequently and regularly. If the child is older, don't be afraid to remind him/her to keep taking fluids.
DO monitor your child if he or she is running a fever, even if they are older.
DO check with your pediatrician if a child runs a temperature for three days or more or if he or she had a fever that went away then suddenly returns.
DON'T give a child aspirin, which has been associated with Reyes Syndrome, a serious condition that can lead to a coma and/or death.
DON'T give alcohol baths and other treatments our grandparents may have used.
DON'T push food. Moderate amounts of food, and even some sugar, are helpful. Watered-down Gatorade (50/50) is one drink I recommend from time to time.
ALWAYS contact your pediatrician if your child is under 2 months of age and he or she has a temperature above 100.4 rectally.

Although some people may want to alternate between acetaminophen and ibuprofen while treating a fever, always check with your pediatrician to see if this is a good strategy. Finally, always check with your pediatrician if you're not clear on how to best handle a sick child or if anything unusual crops up during what seems to be a normal cold.

Hope this helps!

Dr. Collison,

My granddaughter will be 20 months old soon. She rarely talks. She can do anything you ask her to. When she does talk it is clear and precise. Is it normal for a toddler this age not to talk? She has a 5 ½ year old sister that talks constantly!

At her age, we would like her to have a minimum of 3-5 words and by age 2 in the neighborhood of 20 words. We do see sometimes kids that don't talk a lot with older siblings who do talk a lot for them. Without seeing her, I would think she is alright if she does talk occasionally and her speech is good when she does and her understanding is good. If you don't see progression of the language over the next few months it might be worthwhile to have a developmental evaluation but hopefully things will progress and her sister will let her talk.

Hope this helps!